Sunday, April 10, 2005
Not all choices involving the end of life are contentious or make headlines. Consider a 92-year-old who stops eating and drinking and dies peacefully at home two weeks later. That is among the oldest ways humans have chosen the time and manner of their deaths.
Or consider individuals who find themselves on artificial life support. If they retain their faculties or have filed advance directives, they can hasten death by having life-sustaining equipment withdrawn.
But then there are the cases that inevitably pose thorny questions: terminally ill people who have stopped treatment and are near death. Should these people be able to choose to hasten their deaths? Or should they be forced to live a few more weeks, while dignity and control slip away?
The Assembly Judiciary Committee takes up these important questions with a hearing and vote Tuesday. Assembly members Patty Berg, D-Sebastopol, and Lloyd Levine, D-Van Nuys, have introduced a bill modeled on Oregon's Death with Dignity Act. That bill should become law. With proper legal safeguards, individuals with incurable, irreversible diseases who are near death should be able to choose a quick, humane end.
In Oregon, terminally ill people of sound mind with a life expectancy of less than six months may ask for doses of medicine to self-administer to hasten their own deaths. The terminally ill person has to make two oral requests and a written request in the presence of two witnesses. The prescribing doctor and a consulting doctor must confirm that the individual has a life expectancy of less than six months. The prescribing doctor must inform the patient of alternatives, such as comfort care, hospice and pain control. The proposed California Compassionate Choice Act (AB 654) has the same safeguards.
Californians have had seven years to observe Oregon's law. Critics voiced fears that people, particularly the poor and disabled, would be pressured into decisions to end their lives. Those fears have not been borne out. Oregon Department of Human Services data show that those who use the Oregon law overwhelmingly are people at the last stages of cancer, college educated, with health insurance and enrolled in pain and comfort care (egov.oregon.gov/DHS/ph/pas/ docs/year7.pdf).
Very small numbers of terminally ill individuals use the Oregon law to hasten their deaths: 37 in 2004, 39 in 2003, 38 in 2002, 21 in 2001, 27 in 2000, 27 in 1999 and 16 in 1998.
A 2001 study reported in the Journal of the American Medical Association also shows that Oregon doctors have increased use of pain medications, recognition of depression and referrals to hospices - improving the quality of life for the terminally ill.
Lawmakers should act carefully and deliberately on a bill of this nature. But in the end they should pass AB 654. The California Compassionate Choice Act will provide a means for individuals with incurable, irreversible diseases to seek a measure of dignity with legal safeguards as they come to life's end.
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